Skip to main content
AAO-HNSF 2026 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.

Scientific Oral Presentation

Care Equity, Quality, and Safety

Risk for Return to Care in Adult Cochlear Implant Patients in US Integrated Healthcare System

Monday, October 19, 2026
8:30 AM - 8:36 AM PT
Location: 406A

    Presenting Author(s)

  • MT

    Mackenzie J. Thurston, BS

    MD/PhD Student
    Kaiser Permanente Bernard J. Tyson School of Medicine
    Los Angeles, CA, United States

    • Senior Author(s)

  • Sarah S. Connell, MD

    Perioperative Director Medical Staff President Elect
    Kaiser Permanente Bernard J. Tyson School of Medicine
    Agoura Hills, CA, United States

    • Co-Author(s)

  • KR

    Kathryn Royse, PhD

    Research Scientist Investigator
    Kaiser Permanente, United States

  • JG

    John C. Goddard, MD

    Chief of Service, Head and Neck Surgery
    Kaiser Permanente
    Clackamas, Oregon, United States

  • Luke J. Schloegel, MD

    Otolaryngologist, Head and Neck Surgery
    Kaiser Permanente
    Oakland, CA, United States

  • BT

    Betty S. Tsai Do, MD

    Senior Physician
    The Permanente Medical Group
    Danville, California, United States

  • LP

    Liz W. Paxton, PhD

    Senior Director, Data Reporting & Analytics
    Kaiser Permanente, United States

Disclosure(s):
Sarah S. Connell, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Given increased life expectancy, increasing numbers of elderly patients are seeking counsel regarding cochlear implantation surgery. This aging population presents unique post-operative challenges, thus prompting us to investigate the risks of return to care to improve surgical counseling.

Methods: We conducted a retrospective cohort study between 1/1/2010-1/1/2021 of adult cochlear implant recipients within an integrated healthcare system using electronic health record data. Outcomes included return to care, emergency department visits, and readmissions within 90-days post-implantation. Independent variables assessed were patient demographics, household income and education, comorbidities, implant information, and insurance. Multivariable logistic regression was used to identify patient-level risk factors with targeted chart review performed for outcome verification. Odds ratios (OR) and 95% confidence intervals (95% CI) are presented.

Results: 1,916 adult patients underwent primary CI placement. The median age of adult patients undergoing implantation was 53 (IQR:66-75). Rates of RTC were as follows: 7-day=3.2%, 90-day ED=8.7%, 90-day RA=2.2%. Adult Medicaid patients had higher odds of both 7-day RTC (OR=3.52, 95% CI=1.66-7.49, P=0.0013) and 90-day ED visit (OR=2.25, 95% CI=1.35-3.74, P=0.0011) compared to commercial insurance alone. Adult Medicare patients also had higher odds of a 90-day ED visit (OR=1.03, 95% CI=1.01-1.46, P=0.0477). Adult CI 90-day readmissions were higher odds for patients who were underweight compared to normal weight (OR=4.02, 95% CI=1.04-15.57, P=0.0245) and patients with at least 1 comorbidity compared to none (OR=4.48, 95% CI=2.27-8.83, P= <.0001).

Conclusions: Return-to-care following adult cochlear implementation was uncommon and most often driven by reassurance. Targeted patient education and enhanced perioperative support for higher-risk patients may further reduce preventable utilization and improve equity in postoperative care.